Long-Term Results after Surgery for Abdominal Aortic Aneurysm.
10.4326/jjcvs.31.100
- VernacularTitle:腹部大動脈りゅう術後患者の長期遠隔期予後
- Author:
Masahiko Ikebuchi
;
Kengo Nishimura
;
Maromi Tachibana
;
Teruo Maeda
;
Yasushi Kanaoka
;
Shigetsugu Ohgi
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2002;31(2):100-104
- CountryJapan
- Language:Japanese
-
Abstract:
We evaluated long-term survival and morbidity of 191 patients (161 non-ruptured and 30 ruptured) undergoing abdominal aortic aneurysm repair between 1980 and 1997. Thirty-day mortality rates of non-ruptured and ruptured aneurysms were 1.2% and 36.6%, respectively. Hospital death occurred in 3.1% of patients with non-ruptured aneurysms and 53.3% of those with ruptured aneurysms. Cumulative survival rates after successful AAA repair at 5 and 10 years were 76.3% and 42.3%, respectively. These were lower than survival rates in the age- and gender-matched general population. The most frequent cause of late death was cardiac problems (28.8%) including myocardial infarction. Other causes included stroke (19.2%), malignant neoplasm (17.3%), and ruptured recurrent aneurysms at or above the proximal anastomosis (9.6%) including aorto-enteric fistulas. Regarding late vascular complications, recurrent aneurysms at or above the proximal anastomosis were found in 10% of patients, including 3.5% of true aneurysms, 4.7% of anastomotic aneurysms, and 1.8% of aorto-enteric fistulas. Thoracic aortic aneurysms were found in 3.7% and aortic dissection in 4.2%. Cumulative graft patency rates at 10 and 15 years were 97.4% and 90.9%, respectively. Suppressive treatment for arteriosclerosis and continuous careful follow-up with an aggressive diagnostic approach may reduce morbidity and mortality from recurrent aneurysms or coronary artery disease, thereby improving late survival after AAA surgery.
